Blood Pressure Levels and Risks of Dementia: a Nationwide Study of 4.5 Million People

There are inconsistent results on the impacts of controlling blood pressure (BP) on the risk of dementia. We investigated the association between BP and risk of dementia subtypes by antihypertensive treatment and comorbidities. Using the Korean National Health Insurance Service-Health Screening Database from 2009 to 2012, a total of 4 522 447 adults aged 60+ years without a history of dementia were analyzed and followed up for a mean of 5.4 years. Individuals were classified according to their baseline systolic BP (SBP) and diastolic BP; SBP 130 to <140 mm Hg and diastolic BP 80 to <90 mm Hg were used as reference groups. The risk of overall dementia and probable Alzheimer disease was significantly higher in the SBP≥160 and lower SBP groups. These U-shaped associations were consistent regardless of antihypertensive use or comorbidities. The risk of probable vascular dementia (VaD) was not higher among lower SBP groups and increased gradually as SBP increased. Although there was a linear association between SBP and the risk of probable VaD in individuals not taking antihypertensives or without comorbidities, there was a U-shaped association in individuals taking antihypertensives or with comorbidities. Patterns of association between diastolic BP and risk of probable Alzheimer disease or probable VaD were similar to those with SBP, except for the risk of probable VaD in individuals taking antihypertensives. In conclusion, risks of probable Alzheimer disease and probable VaD were different among lower BP groups. Although the risk of dementia appears higher in people with lower BP receiving antihypertensives, this finding may be affected by comorbidities.

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Blood Pressure Variability and the Risk of Dementia

Hypertension ◽

10.1161/hypertensionaha.119.14033 ◽

2020 ◽

Vol 75 (4) ◽

pp. 982-990 ◽

Cited By ~ 1

Author(s):

Jung Eun Yoo ◽

Dong Wook Shin ◽

Kyungdo Han ◽

Dahye Kim ◽

Seung-Pyo Lee ◽

...

Keyword(s):

Blood Pressure ◽

Health Insurance ◽

General Population ◽

Vascular Dementia ◽

National Health Insurance ◽

Blood Pressure Variability ◽

Health Insurance System ◽

National Health Insurance System ◽

Korean National Health Insurance ◽

The Mean

To investigate the association between visit-to-visit variability in blood pressure and the incidence of dementia and its subtypes in a general population, we conducted a population-based retrospective cohort study using the Korean National Health Insurance System database. We identified 7 844 814 subjects without a history of any dementia who underwent ≥3 health examinations from 2005 to 2012 in the Korean National Health Insurance System cohort. Blood pressure variability (BPV) was measured using the variability independent of the mean, coefficient of variation, and SD. During the median follow-up of 6.2 years, there were 200 574 cases of all-cause dementia (2.8%), 165 112 cases of Alzheimer’s disease (2.1%), and 27 443 cases of vascular dementia (0.3%). There was a linear association between higher BPV and outcome measures. In the multivariable adjusted model, the hazard ratios and 95% CIs of all-cause dementia were 1.06 (1.04–1.07) for the highest quartile of variability independent of the mean of diastolic blood pressure only, 1.09 (1.08–1.11) for that of systolic blood pressure only, and 1.18 (1.16–1.19) for that of both systolic and diastolic blood pressure compared with subjects having no highest quartile for BPV. Consistent results were noted for Alzheimer’s disease and vascular dementia using other indices of variability and in various sensitivity and subgroup analyses. BPV is an independent predictor for developing dementia and its subtypes. A dose-response relationship was noted between higher BPV and dementia incidence. Reducing BPV may be a target for preventing dementia in the general population.

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PS 11-06 Relationship between moderate drinking with systolic blood pressure and impact on cardiovascular outcome in Korean National Health Insurance Service – National Sample Cohort (NHIS-NSC)

Journal of Hypertension ◽

10.1097/01.hjh.0000500838.76031.7e ◽

2016 ◽

Vol 34 (Supplement 1) ◽

pp. e333-e334

Author(s):

Jinho Shin ◽

Sungha Park ◽

Soon Kil Kim ◽

Hae Young Lee ◽

Ki Chul Sung ◽

...

Keyword(s):

Blood Pressure ◽

Health Insurance ◽

Systolic Blood Pressure ◽

National Health Insurance ◽

National Health ◽

National Sample ◽

Cardiovascular Outcome ◽

Moderate Drinking ◽

Korean National Health Insurance

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P378Influence of reimbursement of non-vitamin K antagonist oral anticoagulants on overall prescription rates of oral anticoagulation: A nationwide study using the Korean National Health Insurance Data

EP Europace ◽

10.1093/europace/euy015.189 ◽

2018 ◽

Vol 20 (suppl_1) ◽

pp. i67-i67

Author(s):

H T Yu ◽

P S Yang ◽

J Hwang ◽

S Ryu ◽

E Jang ◽

...

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

Vitamin K ◽

Oral Anticoagulants ◽

Vitamin K Antagonist ◽

Health Insurance Data ◽

Nationwide Study ◽

Prescription Rates ◽

Korean National Health Insurance ◽

Insurance Data

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Association between depression and the risk of Alzheimer’s disease using the Korean National Health Insurance Service-Elderly Cohort

Scientific Reports ◽

10.1038/s41598-021-02201-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hyunkyu Kim ◽

Wonjeong Jeong ◽

Junhyun Kwon ◽

Youseok Kim ◽

Eun-Cheol Park ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Depression Group ◽

History Of ◽

Korean National Health Insurance ◽

Elderly Cohort ◽

History Of Depression

AbstractIn this cohort study, we assessed the association between depression and the risk of Alzheimer’s disease from data obtained from the 2002 to 2013 Korean National Health Insurance Service-Elderly Cohort Database, which accounts for 10% of the South Korean population aged > 60 years. A total 518,466 patients were included in the analysis and followed up, unless they were excluded due to death or migration. Patients who sought treatment for depression or dementia within 1 year of the washout period and who were diagnosed with dementia within the 1-year period of the diagnosis of depression were excluded from the study. The risk of dementia was analysed using Cox proportional hazards models. Patients with a history of depression during the follow-up period were at a higher risk of Alzheimer’s disease than those without a history of depression (HR 3.35, CI 3.27–3.42). The severe-depression group exhibited the highest risk of Alzheimer’s disease (HR 4.41, CI 4.04–4.81), while the mild-depression group exhibited a relatively lower risk of Alzheimer’s disease (HR 3.31, CI 3.16–3.47). The risk of Alzheimer’s disease was associated with depression history and an increased severity of depression increased the risk of Alzheimer’s disease.

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Different Effects of Metabolic Syndrome on Dementia According to Dementia Type: Analysis Based on the National Health Insurance Service Database of Gangwon Province in South Korea

10.21203/rs.3.rs-35451/v1 ◽

2020 ◽

Author(s):

YEO JIN KIM ◽

Sang Mi Kim ◽

Dae Hyun Jeong ◽

Sang-Kyu Lee ◽

Moo-Eob Ahn ◽

...

Keyword(s):

Metabolic Syndrome ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

International Classification Of Disease ◽

History Of ◽

Korean National Health Insurance ◽

High Glucose Level ◽

The Relationship

Abstract BackgroundMetabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease. However, the relationshipbetween metabolic syndrome and dementia has remained controversial. Using nationwide population cohort data, we investigated the associationbetween metabolic syndrome and dementia,according to the dementia type.MethodsWe analyzed data of 84,144 individuals,in the aged group of more than 60 years,between January 1, 2009,to December 31, 2009, at Gangwon province by using the information of the(Korean) National Health Insurance Service. After eight years of gap, in 2017, we investigated the relationship between metabolic syndrome and dementia. We classified Dementia either as dementia of the Alzheimer type (AD) or vascular dementia (VD). AD and VD were defined according to criteria in the International Classification of Disease, Tenth Revision, Clinical Modification codes.ResultsMetabolic syndrome was associated with AD, while it was not associated with VD. All five components of metabolic syndrome were associated with AD, independently. However, among components of metabolic syndrome, only the high glucose level was associated with VD. Body Mass Index (BMI), fasting glucose and smoking were also associated with AD. A history of the previous stroke was associated with both AD and VD.ConclusionsMetabolic syndrome was associated with AD, while was not associated with VD. VD was associated only with several risk factors that could affect the vascular state rather than a metabolic syndrome. We suggested that the effect of metabolic syndrome on dementia would be different depending on the type of dementia.

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